CO-CREATE-Ex: Community-engaged Optimization of COVID-19 Rapid Evaluation And TEsting Experiences

项目摘要/摘要 圣地亚哥新冠肺炎感染病例在该县中部和南部持续居高不下 靠近美国/墨西哥边境的社区，主要是拉丁裔居民的家园，他们一直是 受新冠肺炎影响最大的少数族裔社区。为了解决这个问题，我们的第一阶段RADx-Up项目合作 与圣伊西德罗健康(SYH)，一家联邦合格的健康中心和全球行动研究中心(全球 Arc)，一个社会变革组织，共同创造和展示基于聚合酶链式反应的新冠肺炎测试的影响 在圣伊西德罗的项目。到目前为止，我们已经为10,000个社区进行了大约15,000个PCR检测 成员(92%为拉丁裔)，并收到SYH要求将测试计划扩展到其他主要成员的请求 护理诊所地点。响应RFA-OD-22-006，我们将继续与我们的社区(全球ARC)和 临床(SYH)合作伙伴细化、指定、实施和评估实施战略捆绑包 优化新冠肺炎检测，超越目前的聚合酶链式反应检测，专注于FDA授权的新冠肺炎快速检测 抗原检测。使用自行管理的快速抗原测试将使参与者能够建立自我测试的能力 并利用卫生信息技术获得额外的诊所服务。基于初步实施 与该项目成立的社区和科学咨询委员会进行测绘，三项实施 优先考虑了加快快速新冠肺炎检测的持续采用的战略。这三种策略 包括：(1)当前的、无电梯的现场免费检测；(2)由促销员主导的新冠肺炎检测咨询和预防 护理提醒；(3)提供FDA授权的自检试剂盒的自动售货机。我们的主要目标是 要：1)完善和实施我们的多组件实施战略捆绑包和一组相关的 食品和药物管理局授权的快速新冠肺炎检测的成功措施和2)实施和评估我们的 创新、多层次、多组件实施战略捆绑，优化新冠肺炎快速测试 在服务不足的拉美裔社区中，使用跨四个 诊所超过18个月。新冠肺炎疫情突显了参与进来的迫切和必要 向社区各方持续和有意义地投入公共卫生研究，以减少健康差距。 这一建议非常适合提供一套成功的战略和衡量标准，可用于 为服务不足的社区提供服务的环境，同时保持灵活性以适应不断变化的新冠肺炎 风景。

PROJECT SUMMARY/ABSTRACT Cases of COVID-19 infection in San Diego have persistently remained high in the county’s central and southern communities near the US/Mexico border, home to primarily Latino residents who have been one of the ethnic minority communities most impacted by COVID-19. To address this, our Phase I RADx-UP project partnered with San Ysidro Health (SYH), a federally qualified health center, and the Global Action Research Center (Global ARC), a social change organization, to co-create and demonstrate the impact of a PCR-based COVID-19 testing program in San Ysidro. To date, we have administered approximately 15,000 PCR tests for >10,000 community members (92% Latino) and received requests from SYH to scale-out the testing program to additional primary care clinic sites. Responsive to RFA-OD-22-006, we will continue working with our community (Global ARC) and clinical (SYH) partners to refine, specify, implement, and evaluate an implementation strategy bundle that optimizes COVID-19 testing, expanding beyond current PCR testing to focus on FDA-authorized COVID-19 rapid antigen testing. Use of self-administered rapid antigen tests will allow participants to build capacity to self-test and use health information technology to access additional clinic services. Based on initial implementation mapping with the project’s established Community and Scientific Advisory Board, three implementation strategies were prioritized to accelerate sustained uptake of rapid COVID-19 testing. These three strategies include: (1) current, walk-up onsite free testing; (2) promotores-led COVID-19 test counseling and preventive care reminders; (3) vending machines that dispense FDA-authorized self-testing kits. Our primary objectives are to: 1) refine and operationalize our multi-component implementation strategy bundle and a related set of measures of success for rapid FDA- authorized COVID-19 testing and 2) implement and evaluate impact of our innovative, multilevel, and multicomponent implementation strategy bundle to optimize COVID-19 rapid testing among underserved, Latino communities using a roll-out implementation optimization study design across four clinics over 18 months. The COVID-19 pandemic has underscored the urgent and essential need to engage invested community parties continuously and meaningfully in public health research to reduce health disparities. This proposal is well-positioned to provide a set of strategies and measures of success that can be used in settings serving underserved communities while maintaining flexibility to adjust to the changing COVID-19 landscape.